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Providers: Doctors face 'worse' fiscal cliff

As the nation hurtles toward the fiscal cliff, doctors are staring down a much more daunting abyss, a panel of experts said Thursday at POLITICO Pro’s health care breakfast briefing.

Not only do doctors face a 2 percent cut in Medicare reimbursements because of the failure — thus far — to avoid sequestration, but they’re also looking at a 27 percent reduction in pay in the absence of a deal to fix the Medicare payment formula.

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Experts on governors & Medicaid expansion

They’re also worried that, so far, the elements of a possible Medicare fiscal cliff deal — as — suggest that even more provider cuts are on the way.

“Blunt cuts are not reform,” said Rich Umbdenstock, CEO of the American Hospital Association. “We’ve got to reform the health care system and cuts on top of cuts are not going to help. They’re just going to shift cuts once again.”

Gail Wilensky, who led Medicare and Medicaid for President George H.W. Bush, warned that “having this looming out year after year … must really wear on physicians who are actively involved in Medicare wondering what they’re doing being involved in, for them, such an unstable program.”

“All that’s being publicly discussed is reducing payments under the same dysfunctional payment system,” she added.

The solutions under consideration by Congress, the panelists warned, would simply shift costs and apply blunt cuts to a system crying out for reform.

Dan Mendelson, president of Avalere Health, lamented that Congress appeared to benefit politically from the lack of a long-term solution for health care. Short-term, urgent deadlines, he said, amount to “an annuity for members of Congress in terms of the campaign contributions."

This article first appeared on POLITICO Pro at 8:50 a.m. on November 29, 2012.

CORRECTION: A previous version of this story misspelled the name of Rich Umbdenstock.

This article first appeared on POLITICO Pro at 8:50 a.m. on November 29, 2012.

CORRECTION: A previous version of this story misspelled the name of Rich Umbdenstock.

Readers' Comments (18)

these doctors aint staring down anything-who are you trying to bull@#$%--they might loose a few bucks here and there-but someone staring down the barel of something would be a mother with 2 or 3 kids and no husband on welfare-or an older person that cant decide weather they should forget their meds that keep them alive or not pay their rent--please please dont feed me this kinda crap about doctors

And the drip drip drip of disaster for our healthcare system will continue.

Obamacare did one thing- offered coverage to 30 million uninsured. This is an admirable idea, but to suggest that Obamacare will improve care for anyone except the previously uninsured is absurd. To suggest that we will somehow save money by adding 30 million people to the system is the most absurd.

I hope Democrats are ready to defend this dog......because they now own the problems with our healthcare system.....and they are rapidly increasing in number and seriousness.

I am a doctor and I have sent letters to all of my patients telling them that I am retiring as of June 15, 2013, Since Obama's ideology is to redistribute the wealth of this country from producing citizens to the people "less fortunate" because they did not take advantage of our public education system, I refuse to go along with this Socialist's philosophy! 30,000,000 more uninsured being thrust upon my fellow doctors will cause a breakdown of our health care system. The plain truth, which Mr. Obama seems to ignore, is that many of this great nation's doctors will do the same as I will, just call it quits. When you need a doctor and you are told the wait will be two or three months to get an appointment you will head for the emergency room which will be packed 24/7. Goodbye America we had a great run for over 200 years until now, where the "disadvantaged" have taken over and expect everything for free!

My primary care doctor has already retired last year. My new doctor has told me that I got in just in time because he's not taking anymore new Medicare patients. And, two of my specialists who monitor ongoing conditions have told me they'll only see me once a year, instead of every six months. This is really working out well so far. Thanks, libs.

these doctors aint staring down anything-who are you trying to bull@#$%--they might loose a few bucks here and there-but someone staring down the barel of something would be a mother with 2 or 3 kids and no husband on welfare-or an older person that cant decide weather they should forget their meds that keep them alive or not pay their rent--please please dont feed me this kinda crap about doctors

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Yeah, you understand the administration and finance operations of a doctor's office really well. I guess they could only pay their employees a fraction of the wage, or wait until the gov't pays them cents on the dollar to pay the employees. Oh, wait....that violates labor law. Maybe they can charge more to the customer with normal insurance? Oh wait....that would mean all of our health care costs go up????

I am a doctor and I have sent letters to all of my patients telling them that I am retiring as of June 15, 2013, Since Obama's ideology is to redistribute the wealth of this country from producing citizens to the people "less fortunate" because they did not take advantage of our public education system, I refuse to go along with this Socialist's philosophy! 30,000,000 more uninsured being thrust upon my fellow doctors will cause a breakdown of our health care system. The plain truth, which Mr. Obama seems to ignore, is that many of this great nation's doctors will do the same as I will, just call it quits. When you need a doctor and you are told the wait will be two or three months to get an appointment you will head for the emergency room which will be packed 24/7. Goodbye America we had a great run for over 200 years until now, where the "disadvantaged" have taken over and expect everything for free!

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If you don't mind me asking, how old are you, roughly? I ask because I wonder how much sooner you moved up your retirement due to the coming changes.

The Republicans should not, and likely will not, pass a "doctor fix" in this next Congress. That not only bails out doctors who backed Obama on ACA (on the promise that he would pass a doctor fix to restore their reimbursement rates), but would also bail out the Dems on the consequences of the ACA.

Republicans and deal with both issues simply by not taking up the Doctor fix legislation in the House. Just ignore it. It expires. The expiration was written into the ACA, so Republicans can simply say they are supporting the President's program as it was written and funded. And they can say that the ACA got no Republican votes, so it is not within the perview of the GOP to "fix" reimbursement rates since that will raise costs of the ACA.

Basically, "Not our fault! Take it up with the Dems! That was the law they wrote and passed.".

I am a doctor and I have sent letters to all of my patients telling them that I am retiring as of June 15, 2013, Since Obama's ideology is to redistribute the wealth of this country from producing citizens to the people "less fortunate" because they did not take advantage of our public education system, I refuse to go along with this Socialist's philosophy! 30,000,000 more uninsured being thrust upon my fellow doctors will cause a breakdown of our health care system. The plain truth, which Mr. Obama seems to ignore, is that many of this great nation's doctors will do the same as I will, just call it quits. When you need a doctor and you are told the wait will be two or three months to get an appointment you will head for the emergency room which will be packed 24/7. Goodbye America we had a great run for over 200 years until now, where the "disadvantaged" have taken over and expect everything for free!

Sounds like you got into medicine for the wrong reasons. A noble profession such as yours really is better off without you.

I am a doctor and I have sent letters to all of my patients telling them that I am retiring as of June 15, 2013, Since Obama's ideology is to redistribute the wealth of this country from producing citizens to the people "less fortunate" because they did not take advantage of our public education system, I refuse to go along with this Socialist's philosophy! 30,000,000 more uninsured being thrust upon my fellow doctors will cause a breakdown of our health care system. The plain truth, which Mr. Obama seems to ignore, is that many of this great nation's doctors will do the same as I will, just call it quits. When you need a doctor and you are told the wait will be two or three months to get an appointment you will head for the emergency room which will be packed 24/7. Goodbye America we had a great run for over 200 years until now, where the "disadvantaged" have taken over and expect everything for free!

Sounds like you got into medicine for the wrong reasons. A noble profession such as yours really is better off without you.

See Ya D-Bag

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Yeah, he should just work for far less then he's earned before, or better yet, just work for free. It will be interesting to watch and see if Med. School enrollment drops off as the cost of Med School rises while the potential earnings drop off.

Dont forget to bill the koch brothers for your posts. Given your moniker and your comments, I find it hard to believe you are an actual doctor. Just reguritating the koch brothers talking points dont make them true

jpromansic - maybe that mother of 3 with no husband and on welfare should have thought about that before popping out kids she can't support and expects everyone else to pay her and her childrens way. Not only for medical treatment but food, etc. Where is her responsibility in this?.

A "few bucks here and there"? When a doctor or clinic sees hundreds of Medicare patients and they continue to lose money on each one it doesn't pay to see them. Eventually more doctors will just refuse to treat Medicare patients. And where does that leave us?

Doctors have a variety of choices as to which field they want to go in; research is becoming increasing popular and the number of primary care docs is declining quickly.

The "couple of bucks" you mention is probably more then your annual paycheck, welfare check, public assistance checks, etc combined. And they probably have a quarter of a million dollars invested in their practice.

Who is going to treat the increasing large senior and poor people population. Certainly not someone like you who can't write a sentence without foul language.

How much is Media Matters paying you to troll here? Doctors are no different than anyone else- they have to make money. With employee wages, benefits and the crippling costs of malpractice insurance more and more will quit the profession. Already many are seling their practices and joining hospitals.